Article Dans Une Revue Stroke Année : 2021

Hemorrhage Expansion After Pediatric Intracerebral Hemorrhage

Gregoire Boulouis
Jean-François Hak
Basile Kerleroux
Sandro Benichi
Sarah Stricker
  • Fonction : Auteur
Florent Gariel
  • Fonction : Auteur
Quentin Alias
Marie Bourgeois
  • Fonction : Auteur
Philippe Meyer
Manoelle Kossorotoff
  • Fonction : Auteur
Lorenzo Garzelli
Nathalie Boddaert
  • Fonction : Auteur
Andrea Morotti
Thomas Blauwblomme
Olivier Naggara
  • Fonction : Auteur

Résumé

Background and Purpose: Significant hemorrhage expansion (sHE) is a known predictor of poor outcome after an intracerebral hemorrhage (ICH) in adults but remains poorly reported in children. In a large inception cohort, we aimed to explore the prevalence of sHE, its associations with clinical outcomes, and its clinical-imaging predictors in children. Methods: Children admitted between January 2000 and March 2020 at a quaternary care pediatric hospital were screened for inclusion. Sample was restricted to children with 2 computed tomography scans within 72 hours of ICH onset, and a minimal clinical follow-up of months. sHE was defined as an increase from baseline ICH volume by 6 cc or 33% on follow-up computed tomography. Clinical outcome was assessed at 12 months with the King’s Outcome Scale for Childhood Head Injury score and defined as favorable for scores ≥5. Results: Fifty-two children met inclusion criteria, among which 8 (15%) demonstrated sHE, and 18 (34.6%) any degree of expansion. Children with sHE had more frequent coagulation disorders (25.0% versus 2.3%; P =0.022). After multivariable adjustment, only the presence of coagulation disorders at baseline remained independently associated with sHE (adjusted odds ratio, 14.4 [95% CI, 1.04–217]; P =0.048). sHE was independently associated with poor outcome (King’s Outcome Scale for Childhood Head Injury <5A, odds ratio, 5.77 [95% CI, 1.01–38.95]; P =0.043). Conclusions: sHE is a frequent phenomenon after admission for a pediatric ICH and more so in children with coagulation defects. As sHE was strongly associated with poorer clinical outcomes, these data mandate a baseline coagulation work up and questions the need for protocolized repeat head computed tomography in children admitted for pediatric ICH.

Dates et versions

hal-04360182 , version 1 (21-12-2023)

Identifiants

Citer

Gregoire Boulouis, Jean-François Hak, Basile Kerleroux, Sandro Benichi, Sarah Stricker, et al.. Hemorrhage Expansion After Pediatric Intracerebral Hemorrhage. Stroke, 2021, 52 (2), pp.588-594. ⟨10.1161/STROKEAHA.120.030592⟩. ⟨hal-04360182⟩
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